Multi-Disciplinary Expert Perspective on the Management of Type 2 Inflammation-Driven Severe CRSwNP : A Brief Overview of Pathophysiology and Recent Clinical Insights
(2024) In Journal of Asthma and Allergy 17. p.431-439- Abstract
Severe chronic rhinosinusitis with nasal polyposis (CRSwNP) is a disabling airway disease that significantly impacts patients’ lives through the severity of symptoms, the need for long-term medical treatment and the high risk of recurrence post-surgery. Biological agents targeting type 2 immune responses underlying the pathogenesis of CRSwNP have shown effectiveness in reducing polyp size and eosinophilic infiltrate, and in decreasing the need for additional sinus surgeries. However, despite recent progress in understanding and treating the disease, type 2 inflammation-driven severe CRSwNP continues to pose challenges to clinical management due to several factors such as persistent inflammation, polyp recurrence, heterogeneity of... (More)
Severe chronic rhinosinusitis with nasal polyposis (CRSwNP) is a disabling airway disease that significantly impacts patients’ lives through the severity of symptoms, the need for long-term medical treatment and the high risk of recurrence post-surgery. Biological agents targeting type 2 immune responses underlying the pathogenesis of CRSwNP have shown effectiveness in reducing polyp size and eosinophilic infiltrate, and in decreasing the need for additional sinus surgeries. However, despite recent progress in understanding and treating the disease, type 2 inflammation-driven severe CRSwNP continues to pose challenges to clinical management due to several factors such as persistent inflammation, polyp recurrence, heterogeneity of disease, and comorbidities. This article presents the findings of a scientific discussion involving a panel of ear, nose and throat (ENT) specialists and pulmonologists across Sweden and Finland. The discussion aimed to explore current management practices for type 2 inflammation-driven severe CRSwNP in the Nordic region. The main topics examined encompassed screening and referral, measurements of disease control, treatment goals, and future perspectives. The experts emphasized the importance of a collaborative approach in the management of this challenging patient population. The discussion also revealed a need to broaden treatment options for patients with type 2 inflammation-driven CRSwNP and comorbid conditions with shared type 2 pathophysiology. In light of the supporting evidence, a shift in the disease model from the presence of polyps to that of type 2 inflammation may be warranted. Overall, this discussion provides valuable insights for the scientific community and can potentially guide the future management of CRSwNP.
(Less)
- author
- Toppila-Salmi, Sanna ; Bjermer, Leif LU ; Cardell, Lars Olaf LU ; Cervin, Anders LU ; Heinikari, Tuuli ; Lehtimäki, Lauri ; Lundberg, Marie ; Richter, Jens C. LU and Sillanpää, Saara
- organization
- publishing date
- 2024
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- biological therapy, chronic rhinosinusitis, collaboration, Nordic countries, surgery, type 2 immunity
- in
- Journal of Asthma and Allergy
- volume
- 17
- pages
- 9 pages
- publisher
- Dove Medical Press Ltd.
- external identifiers
-
- pmid:38745838
- scopus:85193732956
- ISSN
- 1178-6965
- DOI
- 10.2147/JAA.S447093
- language
- English
- LU publication?
- yes
- id
- 0d478f87-6342-4480-b80b-e5ead72ad0c3
- date added to LUP
- 2024-06-18 13:57:48
- date last changed
- 2024-08-13 18:48:19
@article{0d478f87-6342-4480-b80b-e5ead72ad0c3,
abstract = {{<p>Severe chronic rhinosinusitis with nasal polyposis (CRSwNP) is a disabling airway disease that significantly impacts patients’ lives through the severity of symptoms, the need for long-term medical treatment and the high risk of recurrence post-surgery. Biological agents targeting type 2 immune responses underlying the pathogenesis of CRSwNP have shown effectiveness in reducing polyp size and eosinophilic infiltrate, and in decreasing the need for additional sinus surgeries. However, despite recent progress in understanding and treating the disease, type 2 inflammation-driven severe CRSwNP continues to pose challenges to clinical management due to several factors such as persistent inflammation, polyp recurrence, heterogeneity of disease, and comorbidities. This article presents the findings of a scientific discussion involving a panel of ear, nose and throat (ENT) specialists and pulmonologists across Sweden and Finland. The discussion aimed to explore current management practices for type 2 inflammation-driven severe CRSwNP in the Nordic region. The main topics examined encompassed screening and referral, measurements of disease control, treatment goals, and future perspectives. The experts emphasized the importance of a collaborative approach in the management of this challenging patient population. The discussion also revealed a need to broaden treatment options for patients with type 2 inflammation-driven CRSwNP and comorbid conditions with shared type 2 pathophysiology. In light of the supporting evidence, a shift in the disease model from the presence of polyps to that of type 2 inflammation may be warranted. Overall, this discussion provides valuable insights for the scientific community and can potentially guide the future management of CRSwNP.</p>}},
author = {{Toppila-Salmi, Sanna and Bjermer, Leif and Cardell, Lars Olaf and Cervin, Anders and Heinikari, Tuuli and Lehtimäki, Lauri and Lundberg, Marie and Richter, Jens C. and Sillanpää, Saara}},
issn = {{1178-6965}},
keywords = {{biological therapy; chronic rhinosinusitis; collaboration; Nordic countries; surgery; type 2 immunity}},
language = {{eng}},
pages = {{431--439}},
publisher = {{Dove Medical Press Ltd.}},
series = {{Journal of Asthma and Allergy}},
title = {{Multi-Disciplinary Expert Perspective on the Management of Type 2 Inflammation-Driven Severe CRSwNP : A Brief Overview of Pathophysiology and Recent Clinical Insights}},
url = {{http://dx.doi.org/10.2147/JAA.S447093}},
doi = {{10.2147/JAA.S447093}},
volume = {{17}},
year = {{2024}},
}